前路减压并钛网植骨内固定术在胸腰椎骨折患者神经功能及椎体测量指标中的改善作用

Effect of anterior decompression and internal fixation by titanium mesh bone grafting in improving the nerve function and vertebral detection indexes of patients with thoracic and lumbar vertebrae fracture

目的探讨前路减压并钛网植骨内固定术在改善胸腰椎骨折患者神经功能及椎体测量指标中的效果。方法选取2008年3月～2011年3月于我院采用前路减压并钛网植骨内固定术进行治疗的22例胸腰椎爆裂性骨折患者为观察组,同期选取采用自体髂骨植骨加椎弓根螺钉固定术进行治疗的22例患者为对照组,对两组患者的融合率、术前及术后3、6及12个月的Cobb角、椎间隙高度、矢状径、伤椎高度、矢状面位移率、椎体前缘高度、受压面积和Frankel分级进行统计及比较。结果观察组的融合率高于对照组,Cobb角、椎间隙高度、矢状径、伤椎高度、矢状面位移率、椎体前缘高度、受压面积均优于对照组,Frankel分级改善幅度也大于对照组,差异均有统计学意义(均P<0.05)。结论前路减压并钛网植骨内固定术在改善胸腰椎骨折患者神经功能及椎体测量指标中的效果突出,具有较高的临床应用价值。

Objective To study the effect of anterior decompression and internal fixation by titanium mesh bone grafting in improving the nerve function and vertebral detection indexes of patients with thoracic and lumbar vertebrae fracture. Methods 22 patients with thoracic and lumbar vertebrae fracture who were treated with anterior decompression and internal fixation by titanium mesh bone grafting from March 2008 to March 2011 in our hospital were selected as observation group,and 22 patients who were treated with pedicle screw fixation with autogenous iliac bone graft fusions at the time were selected as control group,then the fusion rate,Cobb angle,height of intervertebral space,kyphosis correction rate, vertebral height,sagittal plane displacement rate,anterior vertebral body height,spinal stenosis index before and after the operation at third,sixth and twelfth month,Frankel classification of two groups were analyzed and compared.Results The fusion rate of observation group was higher than that of control group,Cobb angle,height of intervertebral space,kyphosis correction rate,vertebral height,sagittal plane displacement rate,anterior vertebral body height and spinal stenosis index were all better than those of control group,improvement ranges of Frankel classification were bigger than those of control group,the differences were all statistically significant（all P0.05）.Conclusion The effect of anterior decompression and internal fixation by titanium mesh bone grafting in improving the nerve function and vertebral detection indexes of patients with thoracic and lumbar vertebrae fracture is obvious,and it has high clinical value.